Perioperative hospital mortality at a tertiary paediatric institution
Research in postoperative mortality is scarce. Insight into mortality and cause of death might improve and innovate perioperative care. The objective for this study was to report the 24-hour and 30-day overall, and surgery and anaesthesia-related, in-hospital mortality at a tertiary paediatric hospi...
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| Veröffentlicht in: | British journal of anaesthesia : BJA 2015-10, Vol.115 (4), p.608-615 |
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| container_title | British journal of anaesthesia : BJA |
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| creator | de Bruin, L. Pasma, W. van der Werff, D.B.M. Schouten, T.A.N.J. Haas, F. van der Zee, D.C. van Wolfswinkel, L. de Graaff, J.C. |
| description | Research in postoperative mortality is scarce. Insight into mortality and cause of death might improve and innovate perioperative care. The objective for this study was to report the 24-hour and 30-day overall, and surgery and anaesthesia-related, in-hospital mortality at a tertiary paediatric hospital.
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| doi_str_mv | 10.1093/bja/aev286 |
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All patients <18 yr old who underwent anaesthesia with or without surgery between January 1, 2006, and December 31, 2012, at the Wilhelmina Children's Hospital, Utrecht, The Netherlands, were included in this retrospective cohort study. Causes of death within 30 days were identified and tabulated into four major categories according to principal cause.
A total of 45 182 anaesthetics were administered during this 7-yr period. The all-cause 24-hour hospital mortality was 13.1 per 10 000 anaesthetics (95% CI: 9.9–16.8) and the all-cause 30-day in-hospital mortality was 41.6 per 10 000 anaesthetics (95% CI: 35.9–48.0). In total five patients were partially contributable to anaesthesia (30-day mortality: 1.1/10 000, 95% CI: 0.4–2.6) and four patients were partially contributable to surgery (30-day mortality: 0.9/10 000, 95% CI: 0.2–2.3). Mortality was higher in neonates and infants, children with ASA physical status III and IV, and emergency- and cardiothoracic surgery.
Neonates and infants, children with ASA physical status III or poorer, and emergency- and cardiothoracic surgery are associated with a higher postoperative mortality. Anaesthesia- or surgery-related complications contribute to mortality in only a small amount of the deaths, indicating the relative safety of paediatric surgical and anaesthetic procedures.</description><identifier>ISSN: 0007-0912</identifier><identifier>EISSN: 1471-6771</identifier><identifier>DOI: 10.1093/bja/aev286</identifier><identifier>PMID: 26385669</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adolescent ; Age Factors ; anaesthesia ; Anesthesia - adverse effects ; Anesthesia - statistics & numerical data ; Child ; child mortality ; Child, Preschool ; Cohort Studies ; Female ; Hospital Mortality ; Hospitals, Pediatric - statistics & numerical data ; Humans ; Infant ; Infant, Newborn ; infants, paediatrics, surgery ; Male ; Netherlands ; Perioperative Period - statistics & numerical data ; Retrospective Studies ; Tertiary Care Centers - statistics & numerical data</subject><ispartof>British journal of anaesthesia : BJA, 2015-10, Vol.115 (4), p.608-615</ispartof><rights>2015 The Author(s)</rights><rights>The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com 2015</rights><rights>The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c398t-d9d8e7cfd79d7c2d6ec6cc2a90a9a3911cd2bb5f6eb44c03c614b3363f04abc93</citedby><cites>FETCH-LOGICAL-c398t-d9d8e7cfd79d7c2d6ec6cc2a90a9a3911cd2bb5f6eb44c03c614b3363f04abc93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26385669$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>de Bruin, L.</creatorcontrib><creatorcontrib>Pasma, W.</creatorcontrib><creatorcontrib>van der Werff, D.B.M.</creatorcontrib><creatorcontrib>Schouten, T.A.N.J.</creatorcontrib><creatorcontrib>Haas, F.</creatorcontrib><creatorcontrib>van der Zee, D.C.</creatorcontrib><creatorcontrib>van Wolfswinkel, L.</creatorcontrib><creatorcontrib>de Graaff, J.C.</creatorcontrib><title>Perioperative hospital mortality at a tertiary paediatric institution</title><title>British journal of anaesthesia : BJA</title><addtitle>Br J Anaesth</addtitle><description>Research in postoperative mortality is scarce. Insight into mortality and cause of death might improve and innovate perioperative care. The objective for this study was to report the 24-hour and 30-day overall, and surgery and anaesthesia-related, in-hospital mortality at a tertiary paediatric hospital.
All patients <18 yr old who underwent anaesthesia with or without surgery between January 1, 2006, and December 31, 2012, at the Wilhelmina Children's Hospital, Utrecht, The Netherlands, were included in this retrospective cohort study. Causes of death within 30 days were identified and tabulated into four major categories according to principal cause.
A total of 45 182 anaesthetics were administered during this 7-yr period. The all-cause 24-hour hospital mortality was 13.1 per 10 000 anaesthetics (95% CI: 9.9–16.8) and the all-cause 30-day in-hospital mortality was 41.6 per 10 000 anaesthetics (95% CI: 35.9–48.0). In total five patients were partially contributable to anaesthesia (30-day mortality: 1.1/10 000, 95% CI: 0.4–2.6) and four patients were partially contributable to surgery (30-day mortality: 0.9/10 000, 95% CI: 0.2–2.3). Mortality was higher in neonates and infants, children with ASA physical status III and IV, and emergency- and cardiothoracic surgery.
Neonates and infants, children with ASA physical status III or poorer, and emergency- and cardiothoracic surgery are associated with a higher postoperative mortality. Anaesthesia- or surgery-related complications contribute to mortality in only a small amount of the deaths, indicating the relative safety of paediatric surgical and anaesthetic procedures.</description><subject>Adolescent</subject><subject>Age Factors</subject><subject>anaesthesia</subject><subject>Anesthesia - adverse effects</subject><subject>Anesthesia - statistics & numerical data</subject><subject>Child</subject><subject>child mortality</subject><subject>Child, Preschool</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Hospital Mortality</subject><subject>Hospitals, Pediatric - statistics & numerical data</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>infants, paediatrics, surgery</subject><subject>Male</subject><subject>Netherlands</subject><subject>Perioperative Period - statistics & numerical data</subject><subject>Retrospective Studies</subject><subject>Tertiary Care Centers - statistics & numerical data</subject><issn>0007-0912</issn><issn>1471-6771</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE9LwzAYh4Mobk4vfgDpRRChLmnapDnKmH9goAc9hzR5ixltU5N0sG9vpdOTePpdnveB90HokuA7ggVdVlu1VLDLSnaE5iTnJGWck2M0xxjzFAuSzdBZCFuMCc9EcYpmGaNlwZiYo_UreOt68CraHSQfLvQ2qiZpnR_Hxn2iYqKSCD5a5fdJr8BYFb3Vie1CtHGI1nXn6KRWTYCLwy7Q-8P6bfWUbl4en1f3m1RTUcbUCFMC17XhwnCdGQaaaZ0pgZVQVBCiTVZVRc2gynONqWYkryhltMa5qrSgC3QzeXvvPgcIUbY2aGga1YEbgiScUJGXpMAjejuh2rsQPNSy97YdX5AEy-9scswmp2wjfHXwDlUL5hf96TQC1xPghv5_UT5xMFbYWfAyaAudHqN50FEaZ_86-wLEIooY</recordid><startdate>201510</startdate><enddate>201510</enddate><creator>de Bruin, L.</creator><creator>Pasma, W.</creator><creator>van der Werff, D.B.M.</creator><creator>Schouten, T.A.N.J.</creator><creator>Haas, F.</creator><creator>van der Zee, D.C.</creator><creator>van Wolfswinkel, L.</creator><creator>de Graaff, J.C.</creator><general>Elsevier Ltd</general><general>Oxford University Press</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201510</creationdate><title>Perioperative hospital mortality at a tertiary paediatric institution</title><author>de Bruin, L. ; Pasma, W. ; van der Werff, D.B.M. ; Schouten, T.A.N.J. ; Haas, F. ; van der Zee, D.C. ; van Wolfswinkel, L. ; de Graaff, J.C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c398t-d9d8e7cfd79d7c2d6ec6cc2a90a9a3911cd2bb5f6eb44c03c614b3363f04abc93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adolescent</topic><topic>Age Factors</topic><topic>anaesthesia</topic><topic>Anesthesia - adverse effects</topic><topic>Anesthesia - statistics & numerical data</topic><topic>Child</topic><topic>child mortality</topic><topic>Child, Preschool</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Hospital Mortality</topic><topic>Hospitals, Pediatric - statistics & numerical data</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>infants, paediatrics, surgery</topic><topic>Male</topic><topic>Netherlands</topic><topic>Perioperative Period - statistics & numerical data</topic><topic>Retrospective Studies</topic><topic>Tertiary Care Centers - statistics & numerical data</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>de Bruin, L.</creatorcontrib><creatorcontrib>Pasma, W.</creatorcontrib><creatorcontrib>van der Werff, D.B.M.</creatorcontrib><creatorcontrib>Schouten, T.A.N.J.</creatorcontrib><creatorcontrib>Haas, F.</creatorcontrib><creatorcontrib>van der Zee, D.C.</creatorcontrib><creatorcontrib>van Wolfswinkel, L.</creatorcontrib><creatorcontrib>de Graaff, J.C.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of anaesthesia : BJA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>de Bruin, L.</au><au>Pasma, W.</au><au>van der Werff, D.B.M.</au><au>Schouten, T.A.N.J.</au><au>Haas, F.</au><au>van der Zee, D.C.</au><au>van Wolfswinkel, L.</au><au>de Graaff, J.C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Perioperative hospital mortality at a tertiary paediatric institution</atitle><jtitle>British journal of anaesthesia : BJA</jtitle><addtitle>Br J Anaesth</addtitle><date>2015-10</date><risdate>2015</risdate><volume>115</volume><issue>4</issue><spage>608</spage><epage>615</epage><pages>608-615</pages><issn>0007-0912</issn><eissn>1471-6771</eissn><abstract>Research in postoperative mortality is scarce. Insight into mortality and cause of death might improve and innovate perioperative care. The objective for this study was to report the 24-hour and 30-day overall, and surgery and anaesthesia-related, in-hospital mortality at a tertiary paediatric hospital.
All patients <18 yr old who underwent anaesthesia with or without surgery between January 1, 2006, and December 31, 2012, at the Wilhelmina Children's Hospital, Utrecht, The Netherlands, were included in this retrospective cohort study. Causes of death within 30 days were identified and tabulated into four major categories according to principal cause.
A total of 45 182 anaesthetics were administered during this 7-yr period. The all-cause 24-hour hospital mortality was 13.1 per 10 000 anaesthetics (95% CI: 9.9–16.8) and the all-cause 30-day in-hospital mortality was 41.6 per 10 000 anaesthetics (95% CI: 35.9–48.0). In total five patients were partially contributable to anaesthesia (30-day mortality: 1.1/10 000, 95% CI: 0.4–2.6) and four patients were partially contributable to surgery (30-day mortality: 0.9/10 000, 95% CI: 0.2–2.3). Mortality was higher in neonates and infants, children with ASA physical status III and IV, and emergency- and cardiothoracic surgery.
Neonates and infants, children with ASA physical status III or poorer, and emergency- and cardiothoracic surgery are associated with a higher postoperative mortality. Anaesthesia- or surgery-related complications contribute to mortality in only a small amount of the deaths, indicating the relative safety of paediatric surgical and anaesthetic procedures.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>26385669</pmid><doi>10.1093/bja/aev286</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Age Factors anaesthesia Anesthesia - adverse effects Anesthesia - statistics & numerical data Child child mortality Child, Preschool Cohort Studies Female Hospital Mortality Hospitals, Pediatric - statistics & numerical data Humans Infant Infant, Newborn infants, paediatrics, surgery Male Netherlands Perioperative Period - statistics & numerical data Retrospective Studies Tertiary Care Centers - statistics & numerical data |
| title | Perioperative hospital mortality at a tertiary paediatric institution |
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